title: Varicose vein recurrence and patient satisfaction 10-14 years following combined superficial and perforator vein surgery: a prospective case study.
abstract: OBJECTIVE
  To assess real long-term varicose vein recurrence and patient satisfaction following surgical intervention with combined subfascial endoscopic perforator surgery (SEPS) and superficial venous surgery.
  
  
  METHODS
  Prospective consecutive case study (C3-C4). Patients were included March 1993 to September 1998 and 83/104 legs of 80/100 patients were re-assessed 2008; 71 legs underwent duplex ultrasound scanning (DUS).
  
  
  RESULTS
  The median follow up was 12 years (range 10-14). Twelve patients/legs had undergone additional vein surgery during follow-up. Incompetent lower leg perforators were noted in 18/71 limbs (25%). Following groin surgery 23/51 (45%) showed a duplex detected groin recurrence, neovascularization dominated 18/23. In legs where primary great saphenous vein (GSV) surgery had been performed, groin recurrence was found in 14/37 (38%). Previously unknown deep vein incompetence was detected in 14/71 legs (20%), six had axial reflux. The correlation between DUS-detected recurrence and remaining symptoms and cosmetic result was low. The overall satisfaction was high, 70/82 (85%). Patient satisfaction did not deteriorate over time (p < .557).
  
  
  CONCLUSIONS
  Despite a fair number of DUS-detected recurrences, the overall long-term result, from the patients' point of view was surprisingly favorable. Technically well performed open venous surgery seems to result in a durable long-term outcome.
authors.affiliation: Department of Vascular Surgery, Skaraborg Hospital, Skövde, Sweden. olle.nelzen@vgregion.se
authors.forename: O
authors.initials: O
authors.lastname: Nelzén
authors.forename: I
authors.initials: I
authors.lastname: Fransson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D004724:Endoscopy; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D017060:Patient Satisfaction; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Long-term follow-up; Neovascularization; Patient satisfaction; Perforator surgery; Prospective study; Subfascial endoscopic perforator surgery (SEPS); Varicose vein recurrence; Varicose vein surgery